Individual provider Active NPI

Cynthia Louise Malin, APN

  • Adult Health Nurse Practitioner
  • Willingboro, NJ
National Provider Identifier
1558595801
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00283000 Issued in NJ
Practice address
1113 Hospital Dr
1St Floor
Willingboro, NJ 08046-1103
Phone
(609) 835-5821
Fax
(609) 835-5827
NPI assigned
May 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP010300 PA
Adult Health Nurse Practitioner 363LA2200X SP010300 PA
Adult Health Nurse Practitioner 363LA2200X 26NJ00283000 NJ Primary

Addresses

Primary practice location

1113 Hospital Dr
1St Floor
Willingboro, NJ 08046-1103

Mailing address

500 Grove St
Suite 100
Haddon Heights, NJ 08035-1761
Phone (856) 796-9200

Other identifiers 1

IdentifierTypeStateIssuer
SP010300MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00283000NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

18 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-6000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1558595801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GROVE ST",
            "address_2": "SUITE 100",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "080351761",
            "telephone_number": "856-796-9200",
            "fax_number": "856-796-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 HOSPITAL DR",
            "address_2": "1ST FLOOR",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080461103",
            "telephone_number": "609-835-5821",
            "fax_number": "609-835-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIN",
        "first_name": "CYNTHIA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-14",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010300",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010300",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00283000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP010300",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.